What question did this study set out to answer?

To compare the diagnostic accuracy of midregional pro-atrial natriuretic peptide (MRproANP) measured via a novel sandwich immunoassay against N-terminal pro-B-type natriuretic peptide (NTproBNP) for detecting heart failure in emergency patients.

May 31, 2009Journal of Internal MedicineOpen Access

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic   peptide in the diagnosis of heart failure

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Why the study?

Does MRproANP have comparable diagnostic accuracy to NTproBNP for diagnosing heart failure in patients presenting with dyspnea?

Key Points

To compare the diagnostic accuracy of midregional pro-atrial natriuretic peptide (MRproANP) measured via a novel sandwich immunoassay against N-terminal pro-B-type natriuretic peptide (NTproBNP) for detecting heart failure in emergency patients.
Prospective study of 287 consecutive patients presenting with acute dyspnea to an emergency department.
MRproANP and NTproBNP levels were measured at presentation in a blinded fashion.
Heart failure diagnosis was adjudicated by two independent cardiologists using all available clinical data, including standard BNP levels.
Heart failure was adjudicated in 154 patients (54%), with median MRproANP significantly higher in heart failure versus non-heart failure dyspnea (400 vs. 92 pmol/L, P < 0.001).
Diagnostic accuracy was identical between biomarkers, each showing an area under the receiver operating characteristic curve of 0.92 (P = 0.791 for comparison).
MRproANP provided incremental diagnostic value in the subgroup of patients with ambiguous BNP levels in the grey zone between 100 and 500 pg/mL.

Structured PICO

Does MRproANP have comparable diagnostic accuracy to NTproBNP for diagnosing heart failure in patients presenting with dyspnea?

Population

287 consecutive patients presenting with dyspnea to the emergency department

Intervention

Measurement of midregional pro-atrial natriuretic peptide (MRproANP) using a novel sandwich immunoassay

Comparator

Measurement of N-terminal pro-B-type natriuretic peptide (NTproBNP)

Outcome

Diagnostic accuracy for heart failure (adjudicated by two independent cardiologists using all available clinical data including BNP levels)surrogate

MRproANP is as accurate as NTproBNP for diagnosing heart failure in dyspneic patients and may offer incremental diagnostic value when BNP levels are in the grey zone.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports MRproANP as alternative biomarker in dyspnea; leaves open incremental value and need for prospective outcome trials.

Cite This Study

Potocki et al. (2009) studied this question.

synapsesocial.com/papers/6a726ece75498292b70b85cb https://doi.org/10.1111/j.1365-2796.2009.02135.x

Topics

Heart failure HFrEF treatment

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Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic   peptide in the diagnosis of heart failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic   peptide in the diagnosis of heart failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic peptide in the diagnosis of heart failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic peptide in the diagnosis of heart failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic   peptide in the diagnosis of heart failure

Comparison of midregional pro‐atrial natriuretic peptide with N‐terminal pro‐B‐type natriuretic   peptide in the diagnosis of heart failure